Peyton: a patient story

Traumatic medical event led mother, son to try the RightMed® test

PEYTON’S SITUATION

When Peyton Duncan was 10 years old he was prescribed amoxicillin for an ear infection. Within 24 hours of his first dose Peyton was in the hospital fighting for his life. He had a fever of 104 degrees and developed lesions in his ears, eyes, and throat. Peyton was seen by countless infectious disease doctors, but they couldn’t figure out what was wrong. The doctors continued to prescribe medications to combat his symptoms, but he only got worse.

Finally, after being hospitalized for 16 days and becoming legally blind in his left eye, a diagnosis was made. Peyton had Stevens-Johnson Syndrome (SJS).

“In a nutshell, SJS is the worst, most severe reaction you can have to medication next to anaphylactic shock. Your body attacks itself, and your skin literally begins to fall off. Peyton had hundreds of lesions in his mouth, and the skin on his lips peeled off,” said Peyton’s mom, Jolie Duncan.

According to Mayo Clinic, Stevens-Johnson Syndrome is “a rare, serious disorder of your skin and mucous membranes. It’s usually a reaction to a medication or an infection. Often, it begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters.”

“The doctors continued to prescribe medications to combat his symptoms, but he only got worse.”

THE ONEOME SOLUTION

Life changed drastically for Peyton and his family after Stevens-Johnson Syndrome. “Peyton is 13 years old now; it took us two years to recover, and we spent those two years doing everything we could to save his eyesight,” said his mother, Jolie.

“Our pharmacist has been a godsend. She found the eye drops with the least amount of ingredients to help us care for Peyton. And then, after Peyton had a medication-related flare up this year, she told us about the OneOme RightMed® comprehensive test.”

Given Peyton's medical history, it is important to understand which medications may work better for him, should he end up in the hospital again. Peyton’s pharmacist recommended that Jolie talk to Peyton’s doctor about the RightMed test. The RightMed test is a pharmacogenomic test, sometimes called a medication response test, that analyzes a patient's DNA to predict how he or she will respond to hundreds of medications.

Amoxicillin, the drug that triggered Peyton’s SJS, isn’t included as a medication on the RightMed test, and the test cannot predict or prevent SJS.1 However, if Peyton is in need of medical care again, his doctors will have the RightMed test results on hand as a resource to use in making prescription decisions and to guide which drugs, and how much, to give Peyton in his treatment.

“As soon as we found out about the RightMed test, I knew we had to do it. Within a week, I brought the information to my son’s immunologist, and she ordered the test.”

“His doctors will have the RightMed test results on hand as a resource to use in making prescription decisions and to guide which drugs, and how much, to give Peyton in his treatment.”

THE ONEOME DIFFERENCE

“It was crazy. When we got the RightMed test results back, all of the medications that Peyton had been prescribed in the hospital — the ones that were supposed to make him better when he just kept getting worse — were 'in the red.' It made so much sense; it may have been why he wasn’t getting better.”

Drugs that are binned red2 on the RightMed test report are drugs that are shown, based on a patient’s DNA, to have a major interaction between the drug and the patient’s genes. This means that doctors should use extra caution when prescribing these medications, or they should choose alternative medications altogether. The RightMed test provides doctors with insight into why the drugs are binned red and how to proceed with the medication — if at all. For Peyton's doctors, these results mean more informed prescription decisions that may be safer and more effective for him.

“Before taking the RightMed test it was like going on a road trip without a GPS… just winging it to our next destination. Now, instead of our doctor making a best guess on which medication may or may not work, the test results help provide a roadmap of which medicines may work best, based on our son's DNA. I am forever in debt to our pharmacist for bringing this test to our attention. I’m so grateful to have the information.”

“The reasonable cost was so worth it for me to get this valuable information and peace of mind about Peyton, and I can’t imagine a parent not doing it.”

YEARS OF PRESCRIPTION SUPPORT

Since being diagnosed with SJS, Peyton now has 16 different specialists. Jolie has shared the test results with many of the doctors and is hopeful the information will be used to help inform the doctors' medication choices and dosage levels in the future. Since a person’s DNA doesn’t change, the results will provide years of support for Peyton.

“It takes some of the worrying and wondering away for me when it comes to how Peyton may respond to a medication. It gives me comfort knowing that the doctors now have a resource based on my son's DNA to help them make decisions. There’s information to share; it’s all right there in the test report.”

“I have preached OneOme’s product left and right. What do you have to lose? The reasonable cost was so worth it for me to get this valuable information and peace of mind about Peyton, and I can’t imagine a parent not doing it.”

“Now that Peyton is doing better, I’m planning to ask my doctor to order the test for me. I’ve had so many issues with medications, so for me this test is a no brainer.”

FINDING A NEW NORMAL

Life is returning back to normal — a new normal — for Peyton. He still has lasting effects from his SJS, having lost his eyelashes and suffered lasting damage to his lungs. But his eyesight in his left eye has returned (due in large part to his mother’s persistent care), and he’s now pursuing the things he loves as a 13-year-old.

“Peyton loves art and loves to draw. He takes after my husband who is an art director for a big video game developer. He played tennis and soccer before SJS, and we’d like to get him back into those sports.”

“I like to build stuff, too,” Peyton added in the background after hearing his mom talking about him.

Jolie laughed, “Yes, he’s into robotics.”

As life returns to normal for the Duncan family, Jolie thinks about others who the RightMed test could help, “I pray for the day this test becomes the norm for everyone.”

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The RightMed Pharmacogenomics test has not been validated for use in diagnosis or treatment related of Stevens-Johnson Syndrome, and it does not test for the most common variants associated with SJS in order to predict or prevent it from happening. This case provides anecdotal evidence which must be used by your physician with caution and in any event does and should not replace the independent recommendations of a licensed physician.

With the RightMed pharmacogenomic test, providers receive a clinically actionable report that categorizes drugs into a simple, easy-to-read format:

The report does not cover all medications, such as some common over-the-counter medications.

These results are specific to you and should not be used to guide medication decisions for others.

These results do not answer all questions about drug side effects or drug allergies.

This report does not take into account your previous experience with medications, vitamins, and/or supplements, nor does it take into account other factors not included in this report such as food interactions, age, gender, race/ethnicity, health conditions (i.e., diet, illness or disease), environmental factors (i.e., smoking), and drug-to-drug interactions.

The RightMed test, as with all genomic testing, has limitations. Always discuss the test with your healthcare provider to see if it's right for you.

Make sure you understand the benefits and limits of any test before ordering.

As a matter of practice, OneOme will routinely update its pharmacogenomic database as new information becomes available to the scientific community. As a result of these updates, drug binning and annotations found on the patient’s RightMed pharmacogenomic test report are dependent on the date of generation and/or the database version used to generate that report.